The increased prevalence, morbidity, mortality, and health costs associated with asthma among children suggest the need for accessible asthma education. This study examined the effect of telepharmacy counseling, using interactive compressed video, on metered-dose inhaler (MDI) technique and patient satisfaction among adolescents with asthma in rural Arkansas. The telepharmacy counseling provided accessible education regarding MDI technique for adolescents in this study. Twenty percent of the adolescents who participated had never been shown the appropriate use of an MDI. The study used an experimental design with random assignment of participants to a telepharmacy counseling group (n = 15) or a control group (n = 21). Both groups participated in pre-test, post-test, and 2- to 4-week follow-up assessments for MDI technique and patients satisfaction (follow-up assessment only) via interactive compressed video. Results indicated that from pre-test to follow-up the telepharmacy counseling group showed more improvement in MDI technique than participants in the control group (p < 0.001). There was no significant difference between the telepharmacy counseling group and control group in satisfaction with the instructional sessions (p = 0.132). Both groups had high levels of satisfaction with the telepharmacy sessions. The study findings demonstrated that patient education provided by pharmacists via interactive compressed video was superior to education provided via written instructions on an inhaler package insert. Interactive compressed video is an effective medium for teaching and improving MDI technique in this rural, adolescent, predominantly African-American population.

*Objective: This study describes Arkansas pharmacists' knowledge, attitudes, and beliefs regarding emergency contraception. Methods: A cross-sectional survey was conducted among a convenience sample of pharmacists prior to a continuing education lecture. The 16-item survey included multiple choice and true/false questions to assess knowledge in addition to Likerttype scale questions regarding attitudes and beliefs. Frequency and descriptive statistics were calculated for all variables. Results: Eighty-eight pharmacists completed the survey. A majority (73%) knew that Plan B had been FDA-approved for nonprescription use yet 42% believed that it works by disrupting a newly implanted ovum. On a scale from 1-5 where 5=strongly agree, the mean item score was 3.2 for whether emergency contraception should be available for nonprescription use with counseling and 1.6 for nonprescription use without counseling. When asked what they would do if presented with a request for emergency contraception, 45.8% indicated they would dispense the drug, 22.9% would refer the patient to another pharmacist or pharmacy, 3.6% would refuse to dispense, and 27.7% were not sure. Almost half (48.6%) did not believe they were competent instructing patients on the use of emergency contraception. Conclusions: The results show that pharmacists could benefit from additional training on emergency contraception.

Although most states have laws that explicitly allow physicians to refuse to provide certain medical services, the policies pertaining to pharmacists are less clear. The purpose of this report is to determine which states have laws or regulations that address a pharmacist's right to refuse to dispense prescriptions based on moral grounds. Fifty Boards of Pharmacy were contacted via phone or E-mail regarding regulations as well as active or pending legislation. Information was also solicited from various state Governors' legislative offices and Web sites. Typically, individual state practice codes allow pharmacists to refuse to fill a prescription if in their professional judgment the prescription is outside the scope of practice of the prescriber; if the validity of the prescription is in question; or to protect the health and welfare of the patient. Only five states have a “conscience clause” that allows a pharmacist to refuse to fill or refill certain prescriptions, which he or she finds morally objectionable: Arkansas (contraceptives only), California, Georgia, Mississippi, and South Dakota (abortifacients and assisted suicide only). In contrast, Illinois, Massachusetts, North Carolina, and Pennsylvania have an emergency rule or regulation, which states or implies that all legal prescriptions must be dispensed or transferred. Seventeen states considered proposed bills during their respective 2005 legislative session The rights of pharmacists to refuse to dispense certain prescriptions vary widely from state to state. The protection provided to an individual pharmacist may be very broad or very specific depending on the wording of the statute or regulation.